KANSAS SECRETARY OF STATE
Contact Information
NRO
Not for Profit Corporation
Kansas Secretary of State
Change of Registered Office or Agent
Ron Thornburgh
53-13
Memorial Hall, 1st Floor
All information must be completed or this document will not be accepted for filing.
120 S.W. 10th Avenue
Topeka, KS 66612-1594
(785) 296-4564
Print
Reset
Please complete the form, print, sign and
1. Name of the corporation:
mail to the Kansas Secretary of State with
_____________________________________________________
the filing fee. Selecting 'Print' will print the
Name must match the name on record with the secretary of state
form and 'Reset' will clear the entire form.
2. State of organization: _________________________________
3. The registered office in the state of Kansas is changed to:
Do not write in this space
Address must be a street address. A post office box is unacceptable.
_____________________________________________________
Street address
Kansas
_________________________
______________
_________
City
State
Zip
4. The resident agent in Kansas is changed to:
___________________________________________________________________________________________________________
I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct.
Executed on the ________ of ___________ , _____________
.
Day
Month
Year
Authorized officer
Instruction
Submit this form with the $20 filing fee.
Notice: There is a $25 service fee for all returned checks.
Rev. 12/07/04 jb
K.S.A. 17-6203
Rev. 8/26/03 amc